P-129 Camrelizumab combined with sorafenib versus sorafenib alone in patients with advanced hepatocellular carcinoma: A retrospective study

Abstract

Hepatocellular carcinoma (HCC) is one of the most malignant tumors associated with a dismal prognosis. Immunotherapy can modulate the endogenous immune response against tumors with promising prospects in malignant solid tumors, while targeted therapy is appreciated as an important approach in cancer therapy. However, few studies have evaluated the efficacy and safety of immunotherapy and targeted therapy in combination. The present study aimed to compare camrelizumab plus sorafenib versus sorafenib alone in patients with advanced HCC using a propensity score analysis. Between January and December 2019, a total of 90 patients with advanced HCC in the Second Affiliated Hospital of Army Medical University were retrospectively analyzed. Of the patients involved, 28 patients received combined camrelizumab plus sorafenib treatment, and 62 patients received sorafenib monotherapy. Propensity score matching (PSM) analysis was performed based on the following variables: age, gender, HBV, BCLC stage, tumor size, Child-Pugh score and Eastern Cooperative Oncology Group (ECOG) performance score. The combined-therapy group received camrelizumab 200 mg intravenously every 2 weeks plus sorafenib 400 mg orally once daily and the sorafenib-only group was administered sorafenib 400 mg orally twice daily. The treatment response based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST), progression-free survival (PFS), overall survival (OS) and the relevant adverse effects were evaluated. The patients in the combined-therapy group were associated with older age (p = 0.033) and larger tumor size (p=0.042) compared with patients in the sorafenib-only group. After 1:2 PSM, 25 patients in the combined-therapy group were well matched with 50 patients in the sorafenib-only group. The combined-therapy group showed significantly improved overall response rate (ORR) and disease control rate (DCR) compared with the sorafenib-only group (24.0% vs 4.0%, p=0.025; 48.0% vs 24.0%, p=0.036). The median PFS was significantly longer in the combined-therapy group than the sorafenib-only group (7.1 months vs 6.0 months, p=0.040), while the median OS was similar in the two groups (7.4 vs 7.0 months, p=0.513). No difference was noted in the rate of adverse reactions between the combined-therapy group and the sorafenib-only group (32.0% vs 22.0%, p=0.348), and the symptoms were relieved after treatment. The combination treatment of camrelizumab with sorafenib showed promising efficacy with acceptable safety for the management of advanced HCC, but further studies with larger sample sizes and longer follow-up duration or randomized trials are needed to identify the potential therapeutic value.